From : "A History of the Montreal General Hospital"by H.E. MacDermot, M.D., F.R.C.P.(C.),
published by The Montreal General Hospital 1950

Whilst the medical records for the first 30 years or so are not very
full, the registers of the patients give details of the names, age, nationality,
creed and the diagnosis.

The first name recorded is that of "Richard
King, 39, Anglus, from La Chine, with hepatitis" recommended by
the La Chine Canal Company, on May 3, 1822.
The building oh theLachine
Canal which had been begun the year before, provided many casualties
for the hospital, with such diagnoses as "fracrura, vulnus,"
"contusio," and ustus or ambustio," the two last being synonymous with
burns. As might be expected, there was a great vanety of nationalities
from the very beginning. In May, 1823, for example, the following were
recorded within a few days; Hibernus, Anglus, Americanus, Germanicus, Canadensis,
Scotus, Norwegian, and Welshman. The last two apparently were not judged
worthy of Latin appellations. But the Irish far out·numbered
anyone else and Hibernus and Hiberna (usually shortened to Hib!) were for
long the most numerous entries.

At first the policy of making the patients pay something if possible
was strictly followed, but the entries for charges-usually 5/-or7/-per
week -- became rare after the first few years. A unique entry records that
while the patient was sent in as a "pauper" he was willing to pay 5/-per
week. In most instances the patients were Irish immigrants, than whom no
one could reach greater depths of poverty. They seldom brought anything
with them except disease. There is a note on May 23, 1838, by Dr. Stephenson,
"the fat emigrant this year." Whether this was a sigh of resignation over
what the summer was to bring, or of relief at the opening of navigation
once more, who shall say? Not infrequently they ran away from the hospital.
Mary
Dudeson, Hiberna, admitted with rubeola, is shown as "absconded."
Michael
Harrrngton, "ran out the same day he was admitted." and Thomas
Dowde, on January 15, 1837, is shown on the same day as "Ran out
--through fear I believe-after the nurse had shown liim his bed." James
Fitzgerald, admitted with dropsy is recorded as "Ran away early
in the morning in dread of Jack Ketch.
On May 31,1837, two patients admitted with "rheumatism" asked for their
discharge "sooner than take their medicine." This time they were not Irish.
What the medicine was we are not told.

A great many patients were discharged on account of "irregular conduct",
as many as five in one day. The entries of this kind are much more numerous
in some years than in others, suggesting perhaps that conditions in the
hospital were less congenial at some periods than as others. The discharge
of this type often reads simply "irregular," but sometimes it is qualified
with, "for improper language," "Would not submit to treatment," "For smoking--
second time discharged," "For abusive language to the nurse." Catherine
Fleming, 20, Irish, admitted with dyspepsia on August 7, 1862, was
discharged "for grossly irregular conduct." "Delirium tremens" was
a frequent diagnosis. In the month of September, 1845, seven patients were
admitted with that complaint and there were many others that winter. One
patient admitted with this complaint was discharged as he "Broke double
window." One patient "cut wire screen of window and wrote obscene language
on the wall."

There is a good deal of interest in these particular records from the
point of view of medical history. Some of the methods of treatment are
mentioned; as in the case of S. Goldsmith,
an English immigant, admitted September 27. 1849, with "cholera" and discharged
October 12, "Cured by strong doses of calomel" Another English immigrant
named Nicholas Nealshowed equally strong powers of recovery; his discharge note reads:
"This man recovered from cholera and typhus fever whilst in hospital, both
bad attacks. His height was 6 feet 5 in"

Another had a rather striking history, not the least being his recovery
from several operations. This was Thomas Rolland,
an immigrant; admitted December 15, 1851, with "gelatio:" his discharge
note informs us on May 21,1852, that he died "from urinary infiltration
caused by old neglected stricture. He had been operated on at 10
years of age for stone, at 35 had Chopart's operation performed on both
feet -- had the phalanges of left hand removed -- and lastly had a modification
of Syne's operation, also had amputation of thumb performed by Dr.
Arnoldi."

The first recorded operation in the hospital is on May 14, 1823, when
in a case of compound fracture the thigh was amputated with success by
Dr. Robertson." Sometimes emphasis is laid on the success of the operation
as such; perhaps in the absence of anaesthetics it was often something
to be able to finish an operation at all. For example, in 1823, R.
McMahon was admitted with a "vulnus," from which he died two days
later, the note being made that "The external iliac artery was tied by
Dr.
Stephenson with success as to the operation." In another case
"Paracentesis was performed with success as to the operation by Dr.
Loedel," but the patient died. Sepsis was not always inevitable,
at least not fatally so. On May 4, 1823, in the case of a boy of 11, with
white swelling "amputation of the thigh was performed with success by Dr.
Lyons" and the boy discharged "cured." And several others with the like
result are recorded.

The earliest record of tonsillectomy in the hospital is in the case
of Mary McGinnis, 42, who was admitted
on November29, 1838, with "Cynanch. Tons." and discharged in January, 1839,
"Cured by extirpation."

The diagnoses also are of some interest. They remind us again of the
series of epidemics of typhus and cholera which periodically afflicted
the city. Some of the diagnostic terms are not now used and sometimes
the conditions described are less common or have disappeared. For example,
frostbite was more commonly seen then than now. The winters were
probably no worse than they are now, but the conditions amongst the poor,
especially those spending their fist winter in Canada may have more
severe effects frcrm the cold. The descriptive term generally used was
"gelatus" and occasionally "frostbite." On December 31, 1828, there were
13 admissions for "gelatus," all being immigrants. The winter of 1832·33
must also have been severe, as there were 18 patients with "gelatus" including
several in March, one in April and one in May. In 1845 there were 10 between
December and February, and on March 31, 1857, a patient was admitted with
tetanus and died four days later, with the note "the disease was brought
on by frostbite." Conditions must have been most extraordinary to produce
the entry on June 8, 1838, of
H. Jefferson, 21, from the U.S. with "frozen
foot." He had a toe amputated on June 11 and was
discharged "cured." It may of course have been a late effect.

Some of the diagnoses are not now used, some because we know a little
more, others because we have changed one uncertainty for another, others
again because we do not now see the condition -- chlorosis, for example.
"Whiteswelling" we now know as tuberculosis of the kneejoint; more than
once it is recorded as a reason for amputatron. "Porrigo furfurans" would
not now be indulged in as a diagnosis, nor perhaps "emansio mensium."
"Psora" was a term of infinite elasticity apparently; it appears frequently.
It seems to have been applied to any obscure skin condition. We have
exchanged it for "eczema!" The term "synochus" was another favourite blanket
diagnosis, with reference to any unexplained fever. It is very common in
the early books, but does not appear so much after 1842. Sometimes
if was varied by "Febris continua communis," or lust "Febris." One
man was admitted on December 19, 1837, with typhus, and was discharged
on December 30, with the note, "Now assisting the cook, unknown to the
committee, therefore home."

A change of diagnosis, at least an additional one, was necessary in
the case of Amelia Millard, who was admitted
with "synochus" on August 8, 1837, and discharged on August 22nd, with
the note: "Cured; was brought to bed 9 August '37" and then adds: "Uter.
gest." One Irish immigrant admitted with "typhus" was discharged "cured"
about three weeks later, with the note that "at 10 p.m. Oct. 13 she was
delivered of a daughter." But in another case, in which the order was reversed,
the result was less happy. An English girl died in 1844, with the note;
"She was confined and brought to the hospital 5 days after, having been
neglected by her attendants and consequently took fever and died.

There is little to guide us as to postmortems, although the original
regulations of the hospital called far their being done when possible.
In 1845 a note is made of "abscess found in left lobe of cerebrum".
In the case of Pat Ryan, in 1849, with
"obstruction in oesophagus" the note is: "Died; an extensive abscess caused
by irritating fishbone was found behind the oesophagus, extending from
the second cervical vertebra to the 7th or 8th dorsal." Again, J.
Osborn, admitted in June, 1849, with "morbus cordis" died, showing
"ossification of the whole aorta."

Some miscellaneous notes are as follows. Louis
Laporte, 23, in 1830 was "blown up by gunpowder." Wm.
Rose, 17, came in with a fractured tibia, "running from Ste. Eustache
when the rebels were in arms, he met with the accident." One Prevost,
Canadian, was admitted on August 21,1838, and died the same day from "contus,
etc.; he was knocked down by the racehorse April Fool." James
Miller, 25, "no church," a U.S. immigrant, admitted "for dissection".
Mary
Kelly, Irish, admitted in 1837 with "contusio" is shown as being
discharged on the same day "having requested Dr.
Campbell to procure her an abortion." A seaman admitted with
typhus in l847 "died by hanging himself to a tree in the M.G.H. garden
at 10 p.m." a week later.

The poverty of many of the patients is shown in the note (August 21,1821):

"That as the clothes of many of the patients have never been regularly
washed, etc., a part of the stable be partitioned off for the purpose
of purifying those parts of the wearing apparel of the patients unfit to
be cleaned in the hospital on account of vermin and contagious matter (This
does not comprehend linen)."

The hospital was not long in finding out that it was regarded as a general
refuge. The Committee more than once insists that it be made clear that
the hospital is not an asylum for the aged and infirm.

Sometimes there was difficulty in getting rid of mentally deranged patients.
It was six months before they could get a lunatic woman placed in the asylum
at Quebec; the Grey Nunnery was unable
to take her.

Dr. Holmes complains in 1823 that:

"an inconvenience was felt from patients not leaving the hospital when
discharged."
"Resolved that no provisions shah be given to any patient afterhe or
she shall be
discharged by the Medical Officer in attendance,and if he or she shall
not have left the hospital in 24 hours after such discharge that the patient
shall then be turned out and the secretary shall notify the governor who
has recommended such patient that he may remove such patient if he or she
be notable to leave the hospital."

A little later on (1825) Mr. Beniah Gibb
on his visit says:

"I this day visited the hospital and found everything apparently in
good order except a poor German laying in a shakedown in oneof the
upper passages, apparenty insane, and think he might be removed if possible."

And the Committee explains that

"the German is deranged and could not be kept in the ward with the other
patients."

But the general tenor of all the reports is that of contentment amongst
the patients and of the greatest solicitude for their care.